In plastic and reconstructive craniomaxillofacial surgery, careful preoperative planning is essential to get a successful outcome. Many craniomaxillofacial surgeons have used imaging modalities like conventional radiographs, computed tomography(CT) and magnetic resonance imaging(MRI) for supporting the planning process. But, there are a lot of limitations in the comprehension of the surgical anatomy with these modalities. Medical models made with rapid prototyping (RP) technique represent a new approach for preoperative planning and simulation surgery. With rapid prototyping models, surgical procedures can be simulated and performed interactively so that surgeon can get a realistic impression of complex structures before surgical intervention. The great advantage of rapid prototyping technique is the precise reproduction of objects from a 3-dimensional reconstruction image as a physical model. Craniomaxillofacial surgeon can establish treatment strategy through preoperative simulation surgery and predict the postoperative result.
In recent years, many computer systems that are used for patient diagnostic and treatment purpose s are being introduced within hospitals. Therefore, being in a position to manage the hospital entirely, efforts to integrate their own unique system into one have started. A system values humans and creates the surrounding atmosphere into one which maximizes the abilities of individuals. For this, a scientific integration management operation system is required. The type of system that is demanded due to this requirement is an ERP(Enterprise Resource Planning) system. Lately, even the hospital industry is beginning to show interest in efficient administrative methods. To deliver more predominant medical services, hospitals are trying to introduce scientific administrative methods, whose superiority were proven in enterprises, to the operation system of the hospital organization. ERP values humans over systems, and within a superior system, emphasizes the efficiency of the organization. This sort of process does not just evaluate and manage the working abilities of individuals, but provides an advanced working environment that increases the abilities of members within the organization by fold. Therefore, this research estimates through questionnaires and introductive cases how the introduction of ERP may change the work of customers within hospitals such as the radiologic technology department, and how it may also change the environment of medical services, thus striving to create a radiologic technology department that will not fall behind the times.
The Journal of Korean Society for Radiation Therapy
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v.6
no.1
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pp.146-153
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1994
A modified irradiation technique utilizing a linear accelerator for radiation surgery within the brain was performed in 41 cases of patients with anteriovenous malformation(AVM), astrocytoma, meningioma. etc. The treatment planning and dosimetry of small field for stereotactic radiosurgery with 10 MV X-ray isocentically mounted linear accelerator will be presented dose with field size, the central axis persent depth dose and the combined moving beam dose distribution. The three dimensional dose planning of stereotactic focusing irradiation on small size tumor region was perfomed with dose planning computer system(Therac 2300) and was verified with film dosimetry. The more the number of strip and the wider the angle of arc rotation, the larger were the dose delivered on tumor and the less the dose to surrounding the normal tissues. In this study, the using machine and method was as fellowing. 1) Apparatus : NELAC-1018 10MV X-ray 2) Strip No. : Select the 5-7 strips 3) Cone and field size are from $1{\times}1cm^2$ to $3.5{\times}3.5cm^2$, and special circular cone designed for the purpose of minimized the risk to normal tissue and those size are $0.7{\~}3.6cm{\phi}$.
This study, a sub-one of comprehensive research works titled under "Rural Resources Evaluation System", tried to propose a rational methodology for development of rating tabulation on evaluation items. Firstly, the database system for handling of original/processed data of each evaluation items was constructed, being mainly focussed on the possibilities of data acquisition and statistical treatment. The rating tabulation system developed in the study has the formalized evaluation classes as 2 or 5 for convenience/simplification of analysis works. For each evaluation item in lower step of the goal system, 5 types of rating technique were arranged, which were based on statistical analysis using mean and standard deviation values(Type I), its existence or not(Type II), relative significance of its holding volume(Type III), synthesized weighting scale of its quality and quantity(Type IV), and the others(Type V). And, standardized 4-steps procedure for rating tabulation was proposed. Finally, the rating tabulation system developed in the study was applied to each evaluation item of goal system, from which the numerically-valued ranking criteria was obtained.
This study aimed to evaluate the impact of changes in beam arrangement and arc counts on dosimetric factors in volumetric modulated arc therapy (VMAT) inverse radiation therapy planning for hippocampal-avoidance whole brain radiation therapy (HA-WBRT) by using the Elekta Monaco radiation therapy planning system (RTPs). For coplanar VMAT, both the arc per beam (APB) method and the beam determined arc(BDA) method, which is determined by the number of beams, were applied. For non-coplanar VMAT, the BDA method was utilized, and a total of 9 treatment plans were established by varying the arc counts. All radiation therapy plans met the radiation oncology group (RTOG) 0933 protocol standards, and 14 dosimetric factors were compared and analyzed. The results showed that the BDA-NC VMAT method demonstrated superior performance in terms of planning target volume (PTV) coverage and protection of normal organs, while APB-VMAT was advantageous in terms of hippocampal protection, monitor unit and delivery time. This study is expected to contribute to the efficient establishment of HA-WBRT plans considering the changes in beam arrangement and rotation arc numbers in Monaco RTPs.
PTV considered for the energy, dose distribution exposed to lung and spinal cord, and the characteristic of DVH(Dose Volume Histogram) were compared and investigated by planning the intensity modulated radiation therapy (IMRT) using the photon energies of 6 MV and 10 MV according to tumor location like as the anterior, middle, and posterior regions of lung, and the mediastinum region in lung cancer patients. Our institution installed the linear accelerator (Varian 21 EX-s, USA) equipped with 120 multileaf collimator for lung cancer patients, which is producing the photon energies of 6 MV and 10 MV, and radiation therapy planning was performed with ECLIPSE system (Varian, SomaVision 6.5, USA), which support inverse treatment planning. The tomographic images of 3 mm slice thickness for lung cancer patients were acquired using planning CT, and acquired tomographic images were sent to the Varis system, and then treatment planning was performed in the ECLIPSE system. The radiation treatment planning of the IMRT was processed from various angles according to the regions of the tumor, and using various beam lines according to the size and location of the tumor. The investigation of the characteristic of dose distributions for the energy of 6 MV and 10 MV according to tumor locations in lung cancer patients resulted that the maximum dose of 10 MV energy was 1.2% less than that of 6 MV energy without depending on the tumor location of lung cancer, and the reduction effects of MU were occurred from 10 to 25 MU. Radiation dose exposed to the lung satisfied the less 30% of V20, however radiation dose in 6 MV energy was from 0.1% to 0.5% less than that in 10 MV energy. Radiation dose exposed to the spinal cord for 6 MV energy was from 0.6% to 2.1% less than that for 6 MV energy.
Purpose: The purpose of this study is to investigate dental students' self-perception of clinical care ability after a denture treatment experience. Materials and methods: Of the 58 fourth-year students at the dental school in 2019, 50 students completed the questionnaire concerning their denture treatment session, including treatment planning and pre-prosthetic treatment (4 questions), clinical and laboratory procedures (20 questions), and students' opinions on clinical denture education (4 questions). Each question was answered on a five-point scale, of which points four and five, "agree" and "strongly agree" respectively, were classified as positive responses while points one and two, "disagree" and "strongly disagree" respectively, were classified as negative. Results: All the items on clinical and laboratory procedures received a positive response rate of over 60%, and the overall self-perception of the students appeared to be positive. However, the questions on the ability to perform denture treatment independently after graduation received only 48% of positive answer. Those on patient management, explanations of denture precautions, customized tray production, boxing, and work model production were answered with the highest positive response rate whereas those on treatment planning, final impression acquisition, and surveying, were the lowest in each session. Conclusion: The dental students with experience in denture treatment generally have a positive opinion of their clinical care ability, but further education may be necessary to improve their ability to treat their patients independently.
Park, Do-Geun;Choe, Byeong-Gi;Kim, Jin-Man;Lee, Dong-Hun;Song, Gi-Won;Park, Yeong-Hwan
The Journal of Korean Society for Radiation Therapy
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v.26
no.1
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pp.127-135
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2014
Purpose : By taking advantage of each imaging modality, the use of fused CT/MRI image has increased in prostate cancer radiation therapy. However, fusion uncertainty may cause partial target miss or normal organ overdose. In order to complement such limitation, our hospital acquired MRI image (Planning MRI) by setting up patients with the same fixing tool and posture as CT simulation. This study aims to evaluate the usefulness of the Planning MRI through comparing and analyzing the diagnostic MRI image and Planning MRI image. Materials and Methods : This study targeted 10 patients who had been diagnosed with prostate cancer and prescribed nonhormone and definitive RT 70 Gy/28 fx from August 2011 to July 2013. Each patient had both CT and MRI simulations. The MRI images were acquired within one half hour after the CT simulation. The acquired CT/MRI images were fused primarily based on bony structure matching. This study measured the volume of prostate in the images of Planning MRI and diagnostic MRI. The diameters at the craniocaudal, anteroposterior and left-to-right directions from the center of prostate were measured in order to compare changes in the shape of prostate. Results : As a result of comparing the volume of prostate in the images of Planning MRI and diagnostic MRI, they were found to be $25.01cm^3$(range $15.84-34.75cm^3$) and $25.05cm^3$(range $15.28-35.88cm^3$) on average respectively. The diagnostic MRI had an increase of 0.12 % as compared with the Planning MRI. On the planning MRI, there was an increase in the volume by $7.46cm^3$(29 %) at the transition zone directions, and there was a decrease in the volume by $8.52cm^3$(34 %) in the peripheral zone direction. As a result of measuring the diameters at the craniocaudal, anteroposterior and left-to-right directions in the prostate, the Planning MRI was found to have on average 3.82cm, 2.38cm and 4.59cm respectively and the diagnostic MRI was found to have on average 3.37cm, 2.76cm and 4.51cm respectively. All three prostate diameters changed and the change was significant in the Planning MRI. On average, the anteroposterior prostate diameter decrease by 0.38cm(13 %). The mean right-to-left and craniocaudal diameter increased by 0.08cm(1.6 %) and 0.45cm(13 %), respectively. Conclusion : Based on the results of this study, it was found that the total volumes of prostate in the Planning MRI and the diagnostic MRI were not significantly different. However, there was a change in the shape and partial volume of prostate due to the insertion of prostate balloon tube to the rectum. Thus, if the Planning MRI images were used when conducting the fusion of CT/MRI images, it would be possible to include the target in the CTV without a loss as much as the increased volume in the transition zone. Also, it would be possible to reduce the radiation dose delivered to the rectum through separating more clearly the reduction of peripheral zone volume. Therefore, the author of this study believes that acquisition of Planning MRI image should be made to ensure target delineation and localization accuracy.
Objective: Teeth discoloration is a rare orthodontic complication. The aim of this study was to report the clinical progression of discoloration during orthodontic treatment. Methods: Discolored teeth, detected during orthodontic treatment between January 2003 and December 2012 by a single dentist using similar techniques and appliances, were analyzed. Results: The total number of teeth that showed discoloration was 28. Progression of discoloration was evaluated in only 24 teeth that were observed without any treatment. During the observation period, the discoloration "improved" in 8 of the 24 teeth (33.3%) and was "maintained" in 16 (66.6%). The electric pulp test performed at the time of initial detection of discoloration showed 14.3% positivity, which improved to 21.4% at the final follow-up. None of the initial and final follow-up radiographic findings showed any abnormalities. Conclusions: When teeth discoloration is detected during orthodontic treatment, observation as an initial management is recommended over immediate treatments.
Cancer is the disease of aging and Korea is one of the fastest aging country in the world. Older patients have decreased organ function and stress tolerance, therefore are at high risk of functional decline and developing complication from cancer and cancer treatment. Before beginning cancer treatment, it is important to assess patients' life expectancy, whether the patient is likely to die of cancer or of other comorbidity, and also the risks with cancer treatment. In order to estimate patient's physiologic age, it is recommended to perform geriatric assessment and implement appropriate geriatric intervention together with meticulous supportive care, when planning cancer treatment for older patients. In a resource limited country such as Korea, two step approach of applying screening tool followed by geriatric assessment can be more efficient. Geriatric assessment is used to predict toxicity from cancer treatment such as surgery, radiotherapy, and chemotherapy, predict survival, and also to aid treatment decision. Number of randomized trials are ongoing to compare usual care versus oncogeriatric care, and with these results we expect to improve outcome of older patients with cancer.
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